Rosh (11/10 - 11/23)

Question 1

What syndromes often include omphalocele?

Answer 1

Beckwith-Wiedemann, cloacal exstrophy, or Pentalogy of Cantrell

Question 2

Vulvar cancer risk factors

Answer 2

• VIN or CIN
• prior history of cervical cancer
• cigarette smoking
• lichen sclerosis
• immunodeficiency

Question 3

Most common and second most common type of vulvar cancer

Answer 3

Squamous

Melanoma

Question 4

How common is vulvar cancer?

Answer 4

4th most in the US

Question 5

Biophysiologic mechanism of estrogen

Answer 5

Nuclear receptor binding

Question 6

Contraindications to mesh

Answer 6

Cigarette smoking

Chronic steroids

Question 7

Criteria to diagnose APLS

Answer 7

Anti-beta 2 glycoprotein antibody or anti-cardiolipin antibody > 99 percentile at least twice 12 weeks apart

Question 8

Most common chromosomal abnormality in miscarriage

Answer 8

Monosomy X

Question 9

Two most common medications for urinary urgency and their classes of action

Answer 9

Oxybutynin - antimuscarinic

Mirabegron - adrenergic agonist

Question 10

Vessels injured in vulvar hematomas

Answer 10

Inferior rectal, perineal, posterior labial, urethral

Question 11

Vessels injured in vaginal hematomas

Answer 11

Descending branch of uterine artery

Question 12

Vessel injured in retroperitoneal hematomas

Answer 12

Hypogastric

Question 13

Injury from hip hyperflexion

Answer 13

Femoral nerve - unable to extend knee

Question 14

Injury from pressure on lateral knee

Answer 14

Peroneal nerve - foot drop

Question 15

Prolonged and deep abdominal retraction

Answer 15

Pudendal nerve - vulvar pain

Question 16

Nerve injury during pelvic LND

Answer 16

Obturator - weakened thigh addiction

Question 17

Most frequently injured bladder part in GYN surgery

Answer 17

Dome

Question 18

How many yearly infections constitutes recurrent BV?

Answer 18

More than 3

Question 19

Amsel’s criteria

Answer 19

1) >20% clue cells in wet mount
2) Thin white homogeneous discharge
3) pH > 4.5
4) Positive whiff test

(3/4 makes diagnosis of BV)

Question 20

How long till trying to conceive after MTX?

Answer 20

3 months

Question 21

OB and GYN signs of vertical uterine septum

Answer 21

• infertility or RPL
• PPROM
• malpresentation
• menstrual abnormalities

Question 22

DES abnormalities

Answer 22

• T shaped uterus
• vaginal adenosis
• vaginal ridges
• transverse uterine septum

Question 23

Contraindications to breastfeeding

Answer 23

• infant galactosemia
• maternal HIV
• untreated TB
• HTLV
• drug use
• some chemotherapy
• radiation

Question 24

Two single agent chemotherapy agents for GTN

Answer 24

MTX or dactinomycin

Question 25

What enzyme is stopped by MTX?

Answer 25

Dihydrofolate reductase

Question 26

Which GTN are resistant to chemotherapy?

Answer 26

Placental site and epithelioid trophoblastic tumor

Question 27

Branches of anterior division of internal iliac

Answer 27

Umbilical, uterine, superior vesical, vaginal, inferior gluteal, internal pudendal

Question 28

Branches of posterior division of internal iliac

Answer 28

Iliolimbar, lateral sacral, superior gluteal

Question 29

Branches of external iliac artery

Answer 29

Inferior epigastric, recurrent obturator

Question 30

Venous drainage of ovaries

Answer 30

Right to IVC, left to renal vein

Question 31

Timing for CVS vs amnio

Answer 31

CVS 10-13 6/7 wks | Amnio ideally >15 wks

Question 32

HELLP lab abnormalities for pre eclampsia

Answer 32

Platelets <100,000 Cr >1.1 or double baseline Double of LFTs

Question 33

Third degree laceration categories

Answer 33

3a <50% into external anal sphincter 3b >50% 3c involves internal anal sphincter (4 into rectal mucosa)

Question 34

HPV associated with condyloma accuminata

Answer 34

HPV 6 / 11

Question 35

Muscle cut in episiotomy

Answer 35

Bulbocavernosus

Question 36

Bug and treatment for TSS

Answer 36

Most commonly MSSA or strep; clindamycin / vancomycin

Question 37

Probability of sarcoma in a fibroid

Answer 37

1:350

Question 38

Fetal signs of toxoplasmosis infection

Answer 38

Ventriculomegaly, intracranial calcification, microcephaly, ascites, hepatosplenegaly, IUGR

Question 39

HSV suppression doses

Answer 39

Acyclovir 400 mg BID Famciclovir 250 mg BID Valacyovir 500 - 1000 mg QD